Society to Improve Diagnosis in Medicine Forms Coalition to Address Preventable Diagnostic Errors; Proper Use of Clinical Laboratory Test Is One Goal

SIDM estimates approximately one in 10 patients with serious medical conditions are initially misdiagnosed, a problem that can be addressed if the right medical laboratory test is ordered at the right time for individual patients

Clinical
laboratory leaders know that lab tests are essential to a large proportion
of medical diagnoses. Therefore, any formal effort to reduce diagnostic errors that
affects how doctors order and use lab tests also will impact medical
laboratories that perform those tests.

“Diagnostic error is one of the most important safety
problems in healthcare today and causes the most patient harm,” said Paul L. Epner, CEO and
co-founder of the SIDM, in a news
release. “While many organizations have diagnostic quality on their radar,
it generally is not seen as a top priority. Those who’ve joined the coalition
acknowledge that diagnostic quality and safety are vital to improving
healthcare.”

To participate in the coalition, organizations must promise
to pursue ways to circumvent troublesome diagnostic errors and submit action
plans to the SIDM outlining proposals to diminish such errors. There are no
fees associated with being part of the coalition.

12-Million Patients Each Year Affected by Diagnostic
Errors

Epner told Modern
Healthcare that this coalition is the only one that exists that focuses
solely on diagnostic errors and ways to eradicate them. “There are a lot of
systematic things that we understand are problems, but we aren’t very good at
implementing solutions,” he said. “In terms of having standard solutions, we
are early.”

The National
Academy of Medicine (NAM) defines diagnostic error as “the failure to
establish an accurate and timely explanation of the patient’s health problem(s)
or to communicate that explanation to the patient. Simply put, these are
diagnoses that are missed altogether, wrong, or should have been made much
earlier.”

The SIDM website lists the following key sources for
acquiring data on diagnostic errors:

Autopsy data;

Physician self-reports of experiencing
diagnostic error;

Patient self-reports of experiencing diagnostic
error;

Hospital incident reporting systems;

Statistical analysis of unexpected
hospitalizations;

Research studies designed to measure diagnostic
error; and

Medical malpractice claims data.

“Providing an accurate medical diagnosis is complex and involves uncertainty, but it’s obviously essential to effective and timely treatment,” Paul L. Epner, CEO and co-founder of the SIDM, said in a news release announcing the formation of the coalition. “Nearly everyone will receive an inaccurate diagnosis at some point in their life and for some, the consequences will be grave. Major improvement is needed to systematically identify how to improve diagnostic quality and reduce harm to patients.” (Photo copyright: Society to Improve Diagnosis in Medicine.)

The SIDM
states that diagnostic errors affect an estimated 12-million patients in
the US each year, and that approximately one in 10 patients with a serious
medical condition are initially misdiagnosed. In addition, an estimated 40,000
to 80,000 people die each year from diagnostic errors in US hospitals, and it
is probable that at least that many patients suffer from permanent disability
annually due to improper diagnosis. It is also likely that diagnostic errors
cause more harm to patients than all other medical errors combined and are
responsible for an increasing number of malpractice cases, the SIDM notes.

John’s Hopkins Finds Most Misdiagnoses in Three
Categories of Medicine

A study published in the peer-reviewed journal Diagnosis,
reported that one in three malpractice cases that resulted in death or serious
harm to patients are due to misdiagnosis. The research for this study was
carried out by a team from the Johns Hopkins University
School of Medicine and was funded by the SIDM.

After analyzing more than 55,000 malpractice claims, the
researchers found that 34% of those cases which resulted in death or permanent
disability could be attributed to inaccurate or delayed diagnosis, an SIDM
analysis of the John’s Hopkins study noted.

The research team also examined underlying disease states to
search for misdiagnosis patterns and discovered that three quarters or 74.1% of
the misdiagnosed cases occurred in just three categories of medical conditions:

Cancer (37.8%);

Vascular events (22.8%); and

Infection (13.5%).

These serious cases resulted in $1.8 billion in malpractice
payouts over the course of 10 years, according to the SIDM.

“It is not just inconvenient to have a wrong or delayed
diagnosis. For many patients, misdiagnosis causes severe harm and expense, and
in the worst cases, death,” said David
Newman-Toker, MD, PhD, Director, Armstrong
Institute Center for Diagnostic Excellence at Johns Hopkins University
School of Medicine, in an SIDM
news post. “If we’re going to reduce serious harms from medical errors,
major strides must be made to improve diagnostic accuracy and timeliness. This
study shows us where to focus to start making a difference for patients. It
tells us that tackling diagnosis in these three specific disease areas could
have a major impact on reducing misdiagnosis-related harms.”

The John’s Hopkins research confirms that misdiagnosis is a
common and costly form of medical errors that can have catastrophic results.
The team concluded that it will take a system-wide effort involving physicians,
patients, and their families to improve the accuracy of diagnosis.

The SIDM’s Coalition to Improve Diagnostics is one such
effort and is primarily supported by a $2.45 million grant awarded by the Gordon and Betty Moore Foundation. The main
purpose for this grant was to help increase awareness about diagnostic errors
and develop ways to prevent such errors in the future.

“We think this is a new frontier of safety and quality we
want to be part of,” Daniel
Yang, MD, Program Officer for Diagnostic Excellence Initiative at the Moore
Foundation, told Modern Healthcare.

Clinical laboratory tests are essential to the diagnostic
process. Therefore, lab managers and staff should constantly review their procedures
to ensure accuracy in testing and reporting of results to ordering physicians.
If preventable medical errors are to be significantly reduced, labs will be a
big part of the team effort that will make it happen.